Ultrasound-Guided Microwave Ablation for the Management of Inguinal Neuralgia: A Preliminary Study with 1-Year Follow-up.

Journal Article (Journal Article)

PURPOSE: To evaluate the feasibility and efficacy of ultrasound-guided microwave ablation for the treatment of inguinal neuralgia. MATERIALS AND METHODS: A retrospective review of 12 consecutive ultrasound-guided microwave ablation procedures was performed of 10 consecutive patients (8 men, 2 women; mean age, 41 years [range, 15-64 years]), between August 2012 and August 2016. Inclusion criteria for inguinal neuralgia included clinical diagnosis of chronic inguinal pain (average, 17.3 months [range, 6-46 months]) refractory to conservative treatment and a positive nerve block. Pain response-reduction of pain level and duration and percent pain reduction using a 10-point visual analog scale (VAS) at baseline and up to 12 months after the procedure-was measured. Nine patients had pain after the inguinal hernia repair, and 1 patient had pain from the femoral artery bypass procedure. The microwave ablation procedure targeted the ilioinguinal nerve in 7 cases, the genitofemoral nerve in 4 cases, and the iliohypogastric nerve in 1 case. RESULTS: Average baseline VAS pain score was 6.1 (standard deviation, 2.5). Improved pain levels immediately after the procedure and at 1, 6, and 12 months were statistically significant (P = .0037, .0037, .0038, .0058, respectively). Also, 91.7% (11/12) of the procedures resulted in immediate pain relief and at 1 month and 6 months. At 12 months, 83.3% (10/12) of patients had an average of 69% ± 31% pain reduction. Percent maximal pain reduction was 93% ± 14% (60%-100%), and the average duration of clinically significant pain reduction was 10.5 months (range, 0-12 months.). No complications or adverse outcomes occurred. CONCLUSIONS: Ultrasound-guided microwave ablation is an effective technique for the treatment of inguinal neuralgia after herniorrhaphy.

Full Text

Duke Authors

Cited Authors

  • Lee, KS; Sin, JM; Patil, PP; Hanna, AS; Greenberg, JA; Zea, RD; Brace, CL

Published Date

  • February 2019

Published In

Volume / Issue

  • 30 / 2

Start / End Page

  • 242 - 248

PubMed ID

  • 30717957

Electronic International Standard Serial Number (EISSN)

  • 1535-7732

Digital Object Identifier (DOI)

  • 10.1016/j.jvir.2018.10.031

Language

  • eng

Conference Location

  • United States